Prison Health System Reports Critical of Physicians, Quality of Care
The incompetence of some physicians employed by the state prison health system has led to "serious deficiencies in health care for inmates," according to reports released Tuesday, the Los Angeles Times reports. U.S. District Judge Thelton Henderson commissioned the reports as part of a civil rights lawsuit alleging that inmates receive substandard medical care. In a July 16 letter to Henderson, a panel of two physicians and a nurse practitioner wrote that in their review of about six of the state's 32 prisons, they found the California Department of Corrections hired incompetent doctors who had a history of problems or were not trained to administer the treatments they were providing. They also found the state failed to monitor doctors. Examples cited in the reports include:
- A retired cardio-thoracic surgeon who "manages complex internal medicine patients and makes serious, life-threatening mistakes on a continual basis";
- An obstetrician who treats HIV patients;
- A neurosurgeon who has not been trained to read electrocardiograms but provides health care services to patients with internal medicine problems;
- A corrections official in Sacramento who has authority over hiring physicians but is not a doctor;
- Only one of the prisons in the review had both a chief physician and a surgeon (Reiterman, Los Angeles Times, 8/11);
- Physicians in one unit at Salinas Valley State Prison in Soledad who are only allowed to conduct exams while inmates are still in their cells, which means the only way a physician can have contact with an inmate is through a four-inch by 12-inch food port;
- Clinics at Salinas Valley and Sacramento State Prison that do not have examination tables; and
- Also at Sacramento State, written requests that inmates must complete to see a doctor that "had not been reviewed for months," the San Francisco Chronicle reports (Martin, San Francisco Chronicle, 8/11).
Don Specter, an attorney with the Prison Law Office, which represented inmates in the class-action lawsuit that led to a court settlement and the reports, said, "Doctors need to be assigned to positions consistent with their training and education, and the ones that shouldn't be practicing medicine at all should not be practicing, and new physicians who are competent should be hired immediately" (Benson, Sacramento Bee, 8/11). He added, "We always knew there were physicians who had no business practicing medicine, but we did not know it was this pervasive" (Los Angeles Times, 8/11). Specter also said that Dr. Renee Kanan, the corrections department's medical director, "is working very hard and is doing the best she can with a very difficult bureaucracy ... and grossly inadequate resources" (Sacramento Bee, 8/11).
Margot Bach, a spokesperson for the department, said plans are being developed to improve department headquarters' physician supervision and to ensure that doctors are only treating health problems they are qualified to diagnose them (San Francisco Chronicle, 8/11). "There will be remedial training and greater clinical supervision ... and a stricter adherence to department policies," Bach said, adding, "The department ... takes the health care of inmates very seriously" (Los Angeles Times, 8/11).
Sen. Jackie Speier (D-San Mateo) said the findings are "shameful," adding that she has begun communicating with some of the state's largest HMOs to ask if they will provide to the state executives who can offer recommendations on how to change the system without raising costs dramatically. "Right now, we have a system with extraordinary costs, extraordinary liability and very poor care," Speier said.
Gary Robinson, executive director of the Union of American Physicians and Dentists, said that corrections physicians are typically paid about $134,000, which he said is not aadequate to recruit quality physicians to work in prisons. "Who wants to work inside a prison, most [of] which are located in the middle of the desert?" he said (San Francisco Chronicle, 8/11).